An electronic health record (EHR) is a reliable, complete digital version of a patient’s paper chart that can be updated and accessed in real time. This valuable data improves diagnostics and patient outcomes by aiding clinical decision-making and streamlining processes that once were time-intensive.
When it comes to the usability of EHRs, a HealthIT.gov report found that 75% of healthcare providers say their EHR enables them to deliver better patient care. This article uses the building blocks Wei Wei Lee, MD, MPH, shared in “You, Me, and the Computer Make Three?” with recommendations from Altus on how EHRs enable hospitals to deliver the best level of care possible and the best practices for enhancing patient care.
Equipment and Workflow Considerations
When it comes to creating an EHR program centered around the patient, the success of the program is largely dependent on the ability of the adopter. Whether it be the clinician or IT support team, they need to fully understand the workflow and have the tools and equipment to support EHR.
Various devices are used throughout a patient's stay and in the clinician charting workflow. One of the main pieces of equipment clinicians use to assist with their EMR charting, is mobile workstations. With options in powered carts, medication carts, and even non-powered computers on wheels, they all work to make charting and going into EHR easy.
These workstations on wheels are designed for clinicians and EHRs. They improve workflows and allow clinicians to input data while staying near their patients. It keeps them from forgetting important information since they don’t have to leave. Computer carts also support clinicians no matter how they work. They improve any workflow, so the clinician can focus more on offering an elevated patient experience, rather than focusing on EMR (electronic medical record) charting.
At the 2019-2020 MacLean Center Lecture Series on The Present and Future of the Doctor-Patient Relationship, Wei Wei Lee, MD, MPH delivered the session: "You, Me, and the Computer Make Three?”.
In this session, Wei spoke about the most common complaints surrounding EHRs. Many clinicians said they were spending too much of their working hours entering data, and not enough time communicating with their patients. In a healthcare setting, proper communication is a crucial component of patient satisfaction, and with physicians spending 49% of their work hours interfacing with the EHR, many patients are not receiving the amount of communication necessary.
In order for clinicians to find a happy medium between EHR charting and patient communication, the best way is to follow the “Human Level.” This practice takes EHR and transforms it from a burden with the most complaints from healthcare workers to a tool that enhances patients and clinician communication and education.
The Human Level is used as an acronym and spells out:
- Honor the ‘Golden Minute’
- Use the ‘Triangle of Trust’
- Maximize patient interaction
- Acquaint yourself with the patient’s chart
- Nix the screen
- Let the patient look on while entering information into the EHR
- Eye contact
- Value the computer
- Explain what you’re doing
- Log off
Honor the ‘Golden Minute’
The first minute of the patient encounter is considered the "golden minute.” This minute can make or break a patient’s experience. In the first minute, the clinician should come in completely technology-free to greet the patients and establish a human connection. This establishes the meeting as centered around the patient and improves their overall experience.
Use the ‘Triangle of Trust’
The triangle of trust refers to the overall setup of the room. The workstation should be placed to make a triangle between the clinician and the patient. This allows the clinician to look at the patient and the computer screen without having to shift away. The workstation used in this triangle should allow for the clinician to rotate it to show the patient any information to make them feel more involved during their visit.
Maximize patient interaction
This step focuses on encouraging the patient to interact as much as possible. Always leave time for the patient to ask questions to make sure they fully understand the information, pause for questions, and acknowledge any emotions they may have.
Acquaint yourself with the patient’s chart
Before entering a patient’s room, review the patient’s EHR, take notes of any necessary questions, and fully prepare for the visit. This allows clinicians to use the EHR effectively without alienating their patients.
Nix the screen
For any sensitive topics or concerns, the clinician should completely remove themselves from the EHR. This includes pushing the monitor on the computer cart out of the way, removing hands from the keyboard, and looking the patient in the eyes.
Let the patient look on while entering information into the EHR
Inviting the patient to look at the screen while entering information into the EHR can help build trust, ensure accuracy, and leave less room for errors.
Clinicians should maintain eye contact with their patients as much as possible. It allows them to feel heard and improves their overall experience.
Studies have shown that male clinicians have a tendency to keep their eyes on their keyboard and less on their patients. This makes implementing the Human Level program even more imperative to improving the patient experience.
Value the computer
EHR is not going away. It’s important to acknowledge the opportunities it offers and how helpful of a tool it is. Using EHRs can bring an added engagement tool to patients since physicians can quickly pull up lab results, graphics, and more to help improve the patient experience. Also, since data entry consumes 56% of a typical nurse’s shift, valuing how easy EHRs make the process is imperative.
Explain what you’re doing
Talk out loud while you’re using the computer. Clinicians should be open with what they’re doing in the EHR. This eliminates the patient questioning what is happening while the physician’s attention is elsewhere.
At the end of the appointment, the physician should log off of the EHR while the patient is still in the room. This gives them a chance to ensure the patient’s information is secured and gives the clinician a few minutes at the end of the appointment to establish a human connection once again.
For best practices, it’s important to provide ongoing training to any medical professional who may have to interface with the EHR. This ensures medical students and current residents alike are reminded of the best practices for making EHR usage patient-centered.
EHR is not going anywhere. The ease of use and the move to technology have made EHRs a staple in healthcare facilities. While the switch from physical to electronic health records was easy, care settings still need to make sure their care is patient-centered rather than technology-centered. Implementing the steps in the above guide, with the help of EHR-tailored workstations can improve the EHR workflows for clinicians and patients alike.
Contact Altus for more information on how our workstations on wheels can help improve hospital EHR workflows.